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Healthwatch
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Healthwatch
Healthier Planet, Healthier People
~3.3 mins read
Five small steps toward better health for you and planet Earth.
Everything is connected. You've probably heard that before, but it bears repeating. Below are five ways to boost both your individual health and the health of our planet — a combination that environmentalists call co-benefits.
How your health and planetary health intersect
Back in 1970, Earth Day was founded as a day of awareness about environmental issues. Never has awareness of our environment seemed more important than now. The impacts of climate change on Earth — fires, storms, floods, droughts, heat waves, rising sea levels, species extinction, and more — directly or indirectly threaten our well-being, especially for those most vulnerable. For example, air pollution from fossil fuels and wildfires contributes to lung problems and hospitalizations. Geographic and seasonal boundaries for ticks and mosquitoes, which are carriers of infectious diseases, expand as regions warm.
The concept of planetary health acknowledges that the ecosystem and our health are inextricably intertwined. Actions and events have complex downstream effects: some are expected, others are surprising, and many are likely unrecognized. While individual efforts may seem small, collectively they can move the needle — even ever so slightly — in the right direction.
Five ways to improve personal and planetary health
Adopt plant-forward eating.
This means increasing plant-based foods in your diet while minimizing meat. Making these types of choices lowers the risks of heart disease, stroke, obesity, high blood pressure, type 2 diabetes, and many cancers. Compared to meat-based meals, plant-based meals also have many beneficial effects for the planet. For example, for the same amount of protein, plant-based meals have a lower carbon footprint and use fewer natural resources like land and water.
Remember, not all plants are equal.
Plant foods also vary greatly, both in terms of their nutritional content and in their environmental impact. Learning to read labels can help you determine the nutritional value of foods. It's a bit harder to learn about the environmental impact of specific foods, since there are regional factors. But to get a general sense, Our World in Data has a collection of eye-opening interactive graphs about various environmental impacts of different foods.
Favor active transportation.
Choose an alternative to driving such as walking, biking, or using public transportation when possible. Current health recommendations encourage adults to get 150 minutes each week of moderate-intensity physical activity, and two sessions of muscle strengthening activity. Regular physical activity improves mental health, bone health, and weight management. It also reduces risks of heart disease, some cancers, and falls in older adults. Fewer miles driven in gas-powered vehicles means cleaner air, decreased carbon emissions contributing to climate change, and less air pollution (known to cause asthma exacerbations and many other diseases).
Start where you are and work up to your level of discomfort.
Changes that work for one person may not work for another. Maybe you will pledge to eat one vegan meal each week, or maybe you will pledge to limit beef to once a week. Maybe you will try out taking the bus to work, or maybe you will bike to work when it's not winter. Set goals for yourself that are achievable but are also a challenge.
Talk about it.
It might feel as though these actions are small, and it might feel daunting for any one individual trying to make a difference. Sharing your thoughts about what matters to you and about what you are doing might make you feel less isolated and help build community. Building community contributes to well-being and resilience.
Plus, if you share your pledges and aims with one person, and that person does the same, then your actions are amplified. Who knows, maybe one of those folks along the way might be the employee who decides what our children eat from school menus, or a city planner for pedestrian walkways and bike lanes!
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Healthwatch
Counting Steps Is Good Is Combining Steps And Heart Rate Better?
~4.9 mins read
A new way to assess fitness and estimate health risks.
type 2 diabetes
high blood pressure (hypertension)
coronary atherosclerosis, heart attack, and heart failure
stroke.
Low: 0.0081 or lower
Medium: higher than 0.0081 but lower than 0.0147
High: 0.0147 or higher.
Participants in this study were likely more willing to monitor their activity and health than the average person. And more than 70% of the study subjects were female and more than 80% were white. The results could have been quite different outside of a research setting and if a more diverse group had been included.
The findings were not compared to standard risk factors for cardiovascular disease, such as having a strong family history of cardiovascular disease or smoking cigarettes. Nor were DHRPS scores compared with standard risk calculators for cardiovascular disease. So the value of DHRPS compared with other readily available (and free) risk assessments isn't clear.
The exercise stress testing findings were based on only 21 people. That's far too few to make definitive conclusions.
The cost of a device to continuously monitor heart rate and steps can run in the hundreds of dollars; for many this may be prohibitive, especially since the benefits of calculating the DHRPS are unproven.
Have you met your step goals today? If so, well done! Monitoring your step count can inspire you to bump up activity over time.
But when it comes to assessing fitness or cardiovascular disease risk, counting steps might not be enough. Combining steps and average heart rate (as measured by a smart device) could be a better way for you to assess fitness and gain insights into your risk for major illnesses like heart attack or diabetes. Read on to learn how many steps you need for better health, and why tagging on heart rate matters.
Steps alone versus steps plus heart rate
First, how many steps should you aim for daily? There's nothing special about the 10,000-steps number often touted: sure, it sounds impressive, and it's a nice round number that has been linked to certain health benefits. But fewer daily steps — 4,000 to 7,000 — might be enough to help you become healthier. And taking more than 10,000 steps a day might be even better.
Second, people walking briskly up and down hills are getting a lot more exercise than those walking slowly on flat terrain, even if they take the same number of steps.
So, at a time when millions of people are carrying around smartphones or wearing watches that monitor physical activity and body functions, might there be a better way than just a step count to assess our fitness and risk of developing major disease?
According to a new study, the answer is yes.
Get out your calculator: A new measure of health risks and fitness
Researchers publishing in the Journal of the American Heart Association found that a simple ratio that includes both heart rate and step count is better than just counting steps. It's called the DHRPS, which stands for daily heart rate per step. To calculate it, take your average daily heart rate and divide it by your average daily step count. Yes, to determine your DHRPS you'll need a way to continuously monitor your heart rate, such as a smartwatch or Fitbit. And you'll need to do some simple math to arrive at your DHRPS ratio, as explained below.
The study enrolled nearly 7,000 people (average age: 55). Each wore a Fitbit, a device that straps onto the wrist and is programmed to monitor steps taken and average heart rate each day. (Fitbits also have other features such as reminders to be active, a tracker of how far you've walked, and sleep quality, but these weren't part of this study.)
Over the five years of the study, volunteers took more than 50 billion steps. When each individual's DHRPS was calculated and compared with their other health information, researchers found that higher scores were linked to an increased risk of
The DHRPS had stronger associations with these diseases than either heart rate or step count alone. In addition, people with higher DHRPS scores were less likely to report good health than those who had the lowest scores. And among the 21 study subjects who had exercise stress testing, those with the highest DHRPS scores had the lowest capacity for exercise.
What counts as a higher score in this study?
In this study, DHRPS scores were divided into three groups:
How to make daily heart rate per step calculations
Here's how it works. Let's say that over a one-month period your average daily heart rate is 80 and your average step count is 4,000. That means your DHRPS equals 80/4,000, or 0.0200. If the next month your average heart rate is still 80 but you take about 6,000 steps a day, your DHRPS is 80/6,000, or 0.0133. Since lower scores are better, this is a positive trend.
Should you start calculating your DHRPS?
Do the results described in this study tempt you to begin monitoring your DHRPS? You may decide to hold off until further research confirms actual health benefits from knowing that ratio.
This study merely explored the relationship between DHRPS and risk of diabetes or cardiovascular disease like heart attack or stroke. This type of study can only establish a link between the DHRPS and disease. It can't determine whether a higher score actually causes them.
Here are four other limitations of this research to keep in mind:
The bottom line
Tracking DHRPS or daily activity and other health measures might be a way to improve your health if the results prompt you to make positive changes in behavior, such as becoming more active. Or perhaps DHRPS could one day help your health care provider monitor your fitness, better assess your health risks, and recommend preventive approaches. But we don't yet know if this new measure will actually lead to improved health because the study didn't explore that.
If you already have a device that continuously monitors your daily heart rate and step count, feel free to do the math! Maybe knowing your DHRPS will motivate you to do more to lower your risk of diabetes and cardiovascular disease. Or maybe it won't. We need more research and experience with this measure to know whether it can deliver on its potential to improve health.
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Healthwatch
A Muscle-building Obsession In Boys: What To Know And Do
~4.2 mins read
Body dysmorphic disorder in boys and young men focuses on bulging muscles.
Marked change in physical routines, such as going from working out once a day to spending hours working out every day.
Following regimented workouts or meals, including limiting the foods they're eating or concentrating heavily on high-protein options.
Disrupting normal activities, such as spending time with friends, to work out instead.
Obsessively taking photos of their muscles or abdomen to track "improvement."
Weighing himself multiple times a day.
Dressing to highlight a more muscular physique, or wearing baggier clothes to hide their physique because they don't think it's good enough.
Gather for family meals. Schedules can be tricky. Yet considerable research shows physical and mental health benefits flow from sitting down together for meals, including a greater likelihood of children being an appropriate weight for their body type.
Don't comment on body shape or size. "It's a lot easier said than done, but this means your own body, your child's, or others in the community," says Dr. Vargas.
Frame nutrition and exercise as meaningful for health. When you talk with your son about what you eat or your exercise routine, don't tie hoped-for results to body shape or size.
Communicate openly. "If your son says he wants to exercise more or increase his protein intake, ask why — for his overall health, or a specific body ideal?"
Don't buy protein supplements. It's harder for boys to obtain them when parents won't allow them in the house. "One alternative is to talk with your son's primary care doctor or a dietitian, who can be a great resource on how to get protein through regular foods," Dr. Vargas says.
By the time boys are 8 or 10, they're steeped in Marvel action heroes with bulging, oversized muscles and rock-hard abs. By adolescence, they're deluged with social media streams of bulked-up male bodies.
The underlying messages about power and worth prompt many boys to worry and wonder about how to measure up. Sometimes, negative thoughts and concerns even interfere with daily life, a mental health issue known body dysmorphic disorder, or body dysmorphia. The most common form of this in boys is muscle dysmorphia.
What is muscle dysmorphia?
Muscle dysmorphia is marked by preoccupation with a muscular and lean physique. While the more extreme behaviors that define this disorder appear only in a small percentage of boys and young men, it may color the mindset of many more.
Nearly a quarter of boys and young men engage in some type of muscle-building behaviors. "About 60% of young boys in the United States mention changing their diet to become more muscular," says Dr. Gabriela Vargas, director of the Young Men's Health website at Boston Children's Hospital. "While that may not meet the diagnostic criteria of muscle dysmorphia disorder, it's impacting a lot of young men."
"There's a social norm that equates muscularity with masculinity," Dr. Vargas adds. "Even Halloween costumes for 4- and 5-year-old boys now have padding for six-pack abs. There's constant messaging that this is what their bodies should look like."
Does body dysmorphic disorder differ in boys and girls?
Long believed to be the domain of girls, body dysmorphia can take the form of eating disorders such as anorexia or bulimia. Technically, muscle dysmorphia is not an eating disorder. But it is far more pervasive in males — and insidious.
"The common notion is that body dysmorphia just affects girls and isn't a male issue," Dr. Vargas says. "Because of that, these unhealthy behaviors in boys often go overlooked."
What are the signs of body dysmorphia in boys?
Parents may have a tough time discerning whether their son is merely being a teen or veering into dangerous territory. Dr. Vargas advises parents to look for these red flags:
"Nearly everyone has been on a diet," Dr. Vargas says. "The difference with this is persistence — they don't just try it for a week and then decide it's not for them. These boys are doing this for weeks to months, and they're not flexible in changing their behaviors."
What are the health dangers of muscle dysmorphia in boys?
Extreme behaviors can pose physical and mental health risks.
For example, unregulated protein powders and supplements boys turn to in hopes of quickly bulking up muscles may be adulterated with stimulants or even anabolic steroids. "With that comes an increased risk of stroke, heart palpitations, high blood pressure, and liver injury," notes Dr. Vargas.
Some boys also attempt to gain muscle through a "bulk and cut" regimen, with periods of rapid weight gain followed by periods of extreme calorie limitation. This can affect long-term muscle and bone development and lead to irregular heartbeat and lower testosterone levels.
"Even in a best-case scenario, eating too much protein can lead to a lot of intestinal distress, such as diarrhea, or to kidney injury, since our kidneys are not meant to filter out excessive amounts of protein," Dr. Vargas says.
The psychological fallout can also be dramatic. Depression and suicidal thoughts are more common in people who are malnourished, which may occur when boys drastically cut calories or neglect entire food groups. Additionally, as they try to achieve unrealistic ideals, they may constantly feel like they're not good enough.
How can parents encourage a healthy body image in boys?
These tips can help:
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Healthwatch
Supporting A Loved One With Prostate Cancer: A Guide For Caregivers
~3.7 mins read
Advice for navigating this challenging situation while providing compassionate care and also taking care of yourself.
Looking after a loved one who has prostate cancer can be overwhelming. Caregivers — usually partners, family members, or close friends — play crucial roles in supporting a patient's physical and psychological well-being. But what does that entail? You as a caregiver might not know what to say or how to help.
"Patients diagnosed with advanced cancer are facing their own mortality," says Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of the Harvard Medical School Guide to Prostate Diseases. "And they each process that in different ways."
Dr. Garnick emphasizes the need provide patients and families with the best information possible about the specifics of the diagnosis, symptoms, and available treatments. Some patients have near-miraculous responses to treatment, he says, even when they have very advanced cancer. "We let patients know that there are reasons to be optimistic, as treatments are improving on a regular basis," he says.
Communication
Dr. Garnick points out that clinicians should avoid words or phrases that can leave cancer patients feeling unempowered. A phrase like "Let's not worry about that now," for instance, is dismissive and doesn't respond to a patient's legitimate concerns. Saying "You're lucky your cancer is only stage 2" doesn't allow for the fear and anxiety a patient may have over his disease.
Along similar lines, "It's important for caregivers to be receptive to what their loved ones are saying," Dr. Garnick says. "Instead of minimizing or questioning what your loved one is telling you, try asking 'What do you need? Tell me what you think is going to help you feel better.'"
While it's natural to offer reassurance, you should also give your loved one space to express himself openly without offering quick solutions. Be aware that treatment can lead to emotional ups and downs, so expect mood fluctuations.
One of the most valuable tools you have as a caregiver is the relationship you've built with your loved one over the years. During this challenging time, remind yourself of the bonds you've created together. Shared memories, inside jokes, and mutual interests can provide strength and comfort.
Day-to-day practical support
Managing medications can be challenging. Cancer patients can take a dozen or more pills per day on varying schedules. You can help your loved one stay on track by setting up a pill organizer (available at most drugstores) that sorts medications according to when they're needed.
Patients with advanced prostate cancer are now being treated more often with drug combinations that include chemotherapy as well as hormonal therapies. Chemotherapy can leave patients feeling unusually cold, and patients may also get cold after experiencing hot flashes from hormonal therapy. So keep lots of blankets and warm hats on hand.
Collaborate on a journal where you and your loved one keep health information in one place. It should contain the names and contacts of clinicians on his team, as well as details of his treatment plan. The journal can also double as a diary where you both record treatment experiences.
You might be tasked with coordinating medical appointments. It's important to keep lists of questions you may have. Take notes so you have a record of what doctors and other people on his care team have told you. Also, you should take some time to familiarize yourself with your loved one's insurance policies or Medicare plans so you have a better understanding of what's covered.
Don't forget to take care of yourself!
As a caregiver, it's easy to get lost in your loved one's needs. But caring for someone with cancer while managing household responsibilities can also leave you feeling isolated, burned out, and even depressed. It's essential to also prioritize your own health and well-being.
Make sure that you get enough sleep and exercise. Keep up with your own checkups and screening. Try to eat well, and prepare meals ahead of time to reduce stress and save time on busy days. Take breaks! Caregiving can be intense, so take time to recharge by taking a walk, reading a book, or spending time with friends.
Here are some valuable resources that can help.
Help for Cancer Caregivers provides support on managing feelings and emotions, keeping healthy, day-to-day needs, working together, and long-distance caregiving.
The Prostate Cancer Foundation provides an array of educational materials, including a "caregiver's toolkit" that helps caregivers understand treatment options, side effects, and ways to be actively involved in the decision-making process.
The Patient Advocate Foundation offers case management services to help caregivers and patients understand insurance coverage, financial assistance programs, and other resources that can reduce the financial burden of cancer treatment.
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